Comparison of Long-term Outcome after Palliative Treatment for Unresctable Stage IV Colorectal
Cancer Patients with Obstructive Symptoms: Self Expandable Metal Stents versus Surgery

Yoo, Hong Yeol; Park, Ji Won; Kim, Byung Chang; Sohn, Dae Kyung; Hong, Chang Won; Park, Sung Chan; Choi, Hyo Seong; Oh, Jae Hwan

doi:2011.7.2.58

Korean Journal of Clinical Oncology > Article

ORIGINAL ARTICLE

Korean J Clin Oncol. 2011;7(2): 58-66. doi: https://doi.org/10.14216/kjco.11020

Comparison of Long-term Outcome after Palliative Treatment for Unresctable Stage IV Colorectal Cancer Patients with Obstructive Symptoms: Self Expandable Metal Stents versus Surgery

Hong Yeol Yoo¹, Ji Won Park², Byung Chang Kim², Dae Kyung Sohn², Chang Won Hong², Sung Chan Park², Hyo Seong Choi², Jae Hwan Oh²

¹Department of Colon and Rectal Surgery, Seoul National University College of Medicine, Seoul, Korea
²Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Korea

장폐쇄 증상 있는 절제 불가능한 4기 대장암 환자에서 완화 치료 이후의 장기 성적 비교 : 자가팽창금속스텐트 대 수술

유홍열¹, 박지원², 김병창², 손대경², 홍창원², 박성찬², 최효성², 오재환²

^¹서울대학교병원
^²국립암센터

Corresponding Author: Byung Chang Kim ,Tel: +82-31-920-1649, Fax: +82-31-920-0149, Email: mdzara@ncc.re.kr

Received: September 23, 2011; Accepted: October 20, 2011.

ABSTRACT

Purpose : The aim of this study was to compare the long-term outcomes and the efficacy between palliative selfexpanding metal stent (SEMS) and palliative surgery in unresectable stage IV patients with obstructive symptoms. Methods : Patients with symptomatic unresectable stage IV colorectal cancer who underwent insertion of SEMS (n = 88) or palliative surgery (n = 96) from January 2002 to May 2010 was included in the analysis. The success rates, complications, hospital day, time from treatment procedure to chemotherapy, and the overall survival were compared between the two groups. The independent factors related with overall survival were assessed. Results : Early complication rate in the SEMS group was lower than in the surgery group (26.1% vs 47.9%, P = 0.002). However, the SEMS group had a higher late complication rate and major complication rate than the surgery group. (P < 0.05). The percentage of bowel complications after procedure and additional procedures after complications in the SEMS group were higher than in the surgery group (P = 0.037). The overall survival in the surgery group was higher than in the SEMS group (median 15.7 months vs. 9.1 months), and more patients had to receive additional treatment due to complications in the SEMS group (P< 0.001). Conclusion : SEMS therapy has been considered as relatively simple and less invasive treatment. However, it has more late complications and lower overall survival rates. Therefore, palliative treatment should be applied more carefully considering the site of tumor, symptoms and the status of the patient.

Keywords: unresectable | colorectal neoplasm | stents | palliative care